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Although most of The Sullivan Group’s RSQ® Solutions platform is delivered online via CME/CE courses and clinical performance assessments, there is another major component to the RSQ® Cycle, which involves building clinical risk mitigation strategies directly into the EMR. In 2010, one of our largest clients requested that we develop a library of physician documentation templates for their enterprise EHR system, which happened to be MEDITECH. After several years of development with their medical leadership team, we deployed 137 chief complaint-specific templates with clinical decision support to all 163 emergency departments. Below we have included 2 videos from our President & CEO, Dan Sullivan, MD, JD, FACEP, that outline a few different workflows that can be used by providers to complete their documentation with our PDoc Templates.

Based on our experience, research, and an analysis of
thousands of malpractice cases in acute care, including
emergency departments and urgent care centers, we
have uncovered several critical risk and safety issues
of which you may not be aware.

Over the last 19 years, clients have watched TSG’s library of online courses grow from 10 courses focused on Emergency Medicine to over 275 courses that span the spectrum of healthcare. We are often asked by clients, “Which courses should we focus on first?” While this answer varies greatly based on the specifics of each client, we have taken the liberty of creating a list of courses/topics that we feel are critical for all patient safety initiatives and tend to resonate with clinicians.

Over the last seven years, there has been a significant increase in the number of physicians that are employed by hospitals and health systems. Many of those employment changes were driven by aspects of the PPACA that favored a more “integrated” approach to clinical care. Although the aggressive employment strategy has subsided, there remains a significant interest by hospital systems to more closely align with physician group practices. To this point, let’s explore 4 key areas that hospital systems may want to include in their physician integration strategy, or in some cases, their physician employment and onboarding process.

There are four time-sensitive and life-threatening clinical presentations that every acute care practitioner must master to deliver the best possible care in the safest manner. The first two have been around a while and should be very familiar – Code Trauma and Code STEMI. The next two are less dramatic than trauma and heart attacks, but are no less critical – Code Stroke and Code Sepsis. Here are some highlights of Code Stroke.

With HITECH in full swing and hospitals and health systems across the nation implementing electronic medical record systems, some for the first time, many are finding that the MEDITECH solution, while fantastic for billing, coding and reporting, perhaps leaves a little to be desired where the end-users in the ED are concerned. Many ED providers accustomed to structured paper chart templates found themselves essentially unsupported on the EMR front. Answering the call for , we developed RSQ® Modules for EMRs solution. 

Most physicians are aware that there is a duty to provide reasonable care in the patient-physician relationship. Typically, malpractice liability does not extend to anyone outside of that relationship. However, there are certain extraordinary circumstances in which a physician may have an obligation to a third party, one that is outside the patient-physician relationship.

The threat of a cyber attack seems only to be increasing in healthcare. Recent reports show security issues include losses by large and small providers. Based on the reports in the media, it would appear that no one is immune to this threat. 

Before we look for ways to minimize cyber risk, it's important to understand the state of healthcare cyber liability. 

Too many patients in too little space subjected to inefficient processes. This is the essence of overcrowding in the Emergency Department. In the 40 years since 1975, the number of hospitals has declined from over 7,000 to about 5,700. Hospital bed capacity fell during the same period from 1.5 million to fewer than a million. Meanwhile, the number of ED visits has increased almost every year, totaling 136 million by 2011. The resulting formula for overcrowding is obvious: fewer hospitals + fewer beds + increased ED visits = overcrowding. Most hospital EDs (90%) experience overcrowding at some point. The practical consequence of overcrowding is boarding – when patients are kept in the ED for hours or days after the decision to admit them has been determined.

Since we recently laid out an exercise mapping clinical risks to frequent diagnosis-related claims in Emergency Medicine, we're circling back to recommend a risk mitigation exercise for another area of high risk medicine, Obstetrics.

A recent The Doctors Company analysis identified the most frequent obstetric claims as: 

• 22% Delay in Treatment of Fetal Distress
• 20% Improper Performance of Vaginal Delivery
• 17% Improper Management of Pregnancy